Mental Health’s Missing Piece

Modern mental health care can do better by addressing the things that matter – meaning and purpose.

The following is from the US Department of Health and Human Services. It is representative of how the established mental health world views mental health.

“Ways to maintain positive mental health include:
* Getting professional help if you need it
* Connecting with others
* Staying positive
* Getting physically active
* Helping others
* Getting enough sleep
* Developing coping skills”

Are we addressing the real problem?

Those are all good things. But do you notice anything missing. How about “Finding Meaning and Purpose” or “Developing Spirituality”?

Are we afraid to talk about the things that really matter? The horror one faces when we think our life doesn’t matter. The loneliness of questioning our purpose and wondering if we were only meant to one day be worm food.

I’ve worked and spoken to thousands of people with deep “mental health” issues over the years and these questions are the ones that truly plague them. The same questions our mental health system is ill-equipped or trained to address.

We need to dig deep!

My mother is a retired counselor, and LCSW. She relates how earlier in her career she had the time to truly dig deep with her clients and understand them holistically. She could look through the immediate issues and help them discover real long lasting meaning and purpose. As her field became more and more focused on “evidence-based” practices, this resulted in simplified counseling, six sessions and a worksheet. That might have some easily quantifiable statistical effect, but you can’t dig deep. One result, we’ve never had more people taking drugs or utilizing therapy. Chasing our tail usually just results in more tail chasing.

Meaning and purpose leads to possibilities and healing.

Worse, treatments like Cognitive Behavioral Therapy while no doubt helpful for some, often have little long-term mental health effect for most. According to clinical studies, the effectiveness of CBT might only be about 25-30% short-term and the real long-term effect 10% or less. That means 70 to 90% of people are left with their horrors. I’ve linked below to a couple of reputable studies that show this. You can find many more. Even a study that showed good long-term efficacy for women with PTSD symptoms mentioned that one of the few long-term studies of EMDR( eye movement desensitization and reprocessing), a popular evidence-based practice, not only showed that none of the participants 5-years later showed improvement, but some actually got worse. Don’t think for a second we can’t do better than “evidence based practices” (usually crudely followed by the way) in helping people live deeper, more meaningful lives.

Evidence-based does not always mean life changing

Evidence-based practices are good tools to have, but they are still just tools. To change your life you need these tools and more to find and live with meaning. The kind of meaning and purpose that truly changes lives.

The great Viktor Frankl, author of the best selling psychiatric book Man’s Search for Meaning, looked at mental health from a different point of view than our worksheet addled modern therapeutic view. We all have our issues. We all face struggles. The decisive factor, according to Frankel, to make the decision to live with meaning. For Frankl, in general, those with meaning in their lives are mentally healthy, those without meaning are not. Simple. And I’ve found it to be true. True resiliency and mental health is a complete, balanced life driven by meaning and purpose that motivates you to action every day.

A few of the studies I referenced above:
In the psychosis studies (Trials 9 and 10), outcome was generally poor with only 10% achieving a 25% reduction in total PANSS scores from pretreatment to long-term follow-up, also cost-effectiveness analysis showed no advantages of CBT over non-CBT
The only other PTSD treatment study that examined participants 5 or more years after treatment was a study of eye movement desensitization and reprocessing therapy by Macklin et al. (2000). Thirteen of 17 veterans who had been treated, and 14 who had not been treated, were assessed 5 years following treatment. They found that the modest gains observed at posttreatment had not only disappeared at follow-up, but participants had significantly worsened from their pretreatment scores.